About

Ninani Kombo, MD, is an Associate Professor of Ophthalmology & Visual Science at Yale School of Medicine and an affiliated faculty member at the Yale Institute for Global Health. She received her B.A. from Mount Holyoke College and her M.D. from Yale University School of Medicine, where she also completed her ophthalmology residency. Her fellowship training in Uveitis and Ocular Immunology was conducted at The Massachusetts Eye Research and Surgery Institution (MERSI) under the mentorship of Dr. C. Stephen Foster, where she served as the Chief Clinical Fellow. Dr. Kombo has been on the faculty at Yale since 2014, serving as the Director of the Uveitis Service and as a comprehensive ophthalmologist. She is also the Director of Medical Student Education in Ophthalmology. Her research interests include investigating outcomes in patients with retinal vasculitis, acute retinal necrosis, and ocular cicatricial pemphigoid, as well as exploring genetic markers in conditions such as primary retinal vasculitis. She is actively involved in curriculum design for medical student ophthalmology education, focusing on innovative teaching methods like video lectures, mini-lectures, and near-peer teaching. Additionally, Dr. Kombo has volunteered extensively in Nassau, Bahamas, providing resident teaching and care for underserved populations, and is working to establish international collaborations, including a partnership with the LV Prasad Institute in Hyderabad, India.

Research topics

• Medicine
• Internal medicine
• Family medicine
• Demography
• Immunology
• Optometry
• Surgery
• Pathology
• Ophthalmology
• Dermatology
• Medical education

Selected publications

• Review and Revision of a Preclerkship Ophthalmology Curriculum by senior medical students

  Journal of Academic Ophthalmology · 2026-01-30

  articleOpen accessSenior author

  Background: Curricular time dedicated to ophthalmology is limited in undergraduate medical education. High-quality, early exposure to ophthalmology is necessary both as foundational training for all future physicians and to foster interest in the field. Purpose: Through a student-led review, the present study aimed to evaluate and revise the preclinical ophthalmology curriculum at a medical school in the Northeastern United States. Methods: Four senior medical students systematically evaluated the completeness and instructional effectiveness of preclinical ophthalmology curriculum materials for the 2024-2025 academic year. We evaluated alignment of content with the Association of University Professors of Ophthalmology (AUPO) standardized objectives and instructional design alignment with Mayer’s principles of multimedia learning. Student reviewers independently reviewed curriculum materials, followed by consensus meetings to develop a unified set of recommended changes. The director of medical student ophthalmology education conducted a final round of review. Revised curriculum was implemented September-October 2024. Results: All 12 major AUPO objectives were covered in the curriculum. However, 28% of the 116 subobjectives were absent from lecture slides, and 9.5% were missing from both lecture and seminar materials. Case-based teaching was used for 28% of distinct clinical diagnoses presented in lectures. Across 8 lectures comprising 561 total slides, we proposed 132 modifications, for an average of 16.5 changes per lecture. Recommendations focused on improving content coverage, increasing case-based examples, and encouraging participation to facilitate engagement and retention. Conclusion: The ophthalmology preclinical medical school curriculum used in this study did not fully address several AUPO learning objectives. This initiative represented a second round of curriculum evaluation by senior medical students, who are capable of fostering sustainable improvements in medical education to optimize ophthalmology training for future physicians.

  PublisherOA PDFDOI

• Consensus disease definitions for ophthalmic immune-related adverse events of immune checkpoint inhibitors

  Journal for ImmunoTherapy of Cancer · 2025-04-01 · 15 citations

  articleOpen access

  Ophthalmic immune-related adverse events (Eye-irAEs) from immune checkpoint inhibitors can cause visual morbidity. The absence of standardized definitions for Eye-irAEs not only impedes the development of evidence-based treatments but also progress in translational research. The objective of this study was to develop consensus guidance for an approach to Eye-irAEs.Four ophthalmic physicians (uveitis specialists and neuro-ophthalmologists) drafted Eye-irAE consensus guidance and definitions, which were reviewed by the multidisciplinary Eye-irAE definition panel. The panel was divided into Group A (Neuro-ophthalmology/Orbital Disease) and Group B (Uveitis/Ocular Surface Disease). A modified Delphi consensus process was used, with two rounds of anonymous ratings by panelists and two meetings to discuss areas of controversy. For each disorder, five diagnostic components were evaluated: symptoms, examination findings, laboratory studies/imaging findings, diagnostic criteria, and treatment. Panelists rated content for usability, appropriateness and accuracy on 9-point scales in electronic surveys and provided free-text comments. Aggregated survey responses were incorporated into revised definitions. Consensus was based on numeric ratings using the RAND Corporation/ University of California Los Angeles Health Services Utilization Study (RAND/UCLA) Appropriateness Method with prespecified definitions.29 panelists from 25 academic medical centers voted on 114 rating scales (66 neuro-ophthalmic/orbital disease components, 48 uveitis/ocular surface disease components); of these, 86.3% (57/66) in Group A and 89.6% (43/48) in Group B reached first-round consensus. After revisions, all items except 6.1% (4/66) in Group A and 1.6% (1/60) in Group B received second-round consensus. Consensus definitions were achieved for 10/11 neuro-ophthalmic/orbital disorders: optic neuritis, inflammatory optic disc edema, arteritic ischemic optic neuropathy, optic perineuritis, orbital inflammation, thyroid eye disease-like orbital inflammation, cavernous sinus syndrome, oculomotor mononeuritis, trochlear mononeuritis, and abducens mononeuritis. Consensus definitions were achieved for 9/10 uveitis/ocular surface disorders: anterior uveitis, intermediate uveitis, posterior uveitis, panuveitis, Vogt-Koyanagi-Harada-like syndrome, sarcoidosis-like syndrome, acute macular neuroretinopathy, dry eye disease, and scleritis.These disease definitions establish a standardized classification for Eye-irAE, highlighting differences between irAEs and other inflammatory disorders. Importantly, diagnostic certainty does not always align directly with the need to treat as an Eye-irAE. Given the consensus from this representative panel group, it is anticipated the definitions will be used broadly across clinical and research settings.

  PublisherDOI

• Persistent Anterior Uveitis Following Cataract Surgery

  Ocular Immunology and Inflammation · 2025-05-22 · 1 citations

  articleSenior authorCorresponding

  PURPOSE: To determine the incidence of and risk factors for persistent anterior uveitis following cataract surgery. METHODS: This was a retrospective cohort study of patients who underwent cataract surgery at a tertiary referral center in Connecticut, USA. Those with prior uveitis, complex ocular pathology, concurrent procedures, and surgical complications were excluded. The outcome was development of persistent anterior uveitis, defined as anterior chamber cell grade ≥ 0.5+ and steroid treatment beyond two months. Patients who did and did not develop persistent anterior uveitis were compared using univariate and multivariate analysis. RESULTS: = 0.013). In multivariate analysis, older age was associated with a significantly lower likelihood of persistent anterior uveitis (adjusted odds ratio (AOR) = 0.963, 95% confidence interval (CI)=[0.942, 0.984]), whereas Black race (AOR = 9.102, 95% CI = [4.836, 17.133]) and wet age-related macular degeneration (AOR = 37.700, 95% CI = [6.408, 221.792]) were associated with a significantly higher likelihood. CONCLUSIONS: In this study, 1.1% of eyes developed persistent anterior uveitis following cataract surgery. Younger age, Black race, and wet age-related macular degeneration should be investigated as potential risk factors to improve its prophylaxis, identification, and management.

  PublisherDOI

• Uveitis Onset and Flare-Up: Does the Time of Year Matter?

  Ocular Immunology and Inflammation · 2024-02-27 · 3 citations

  articleSenior authorCorresponding

  PURPOSE: This retrospective chart review tests the hypothesis that initial presentation and flare-up of non-infectious anterior, intermediate, and posterior uveitis varies by month, temperature season, and calendar season among the patient population in Connecticut. METHODS: testing evaluated variation in uveitis presentation based on month, calendar season, and temperature. RESULTS: 353 cases of endogenous uveitis were identified among 272 patients. There was no significant variation by month, calendar season, or temperature across the entire population. There was no significant variation by temperature when assessing anterior uveitis, intermediate uveitis, posterior uveitis, and panuveitis cases separately. Though flare-ups did not show any significant seasonal trends, there was significant variation by temperature for new uveitis episodes. Uveitis episodes in patients with autoimmune conditions were shown to have significant variation by temperature. Uveitis episodes in HLA-B27 positive patients were found to have significant variation by both temperature and month. CONCLUSION: While variation by month, calendar season, or temperature is not present for all uveitis patients, a subset of patients with comorbid autoimmune conditions, specifically HLA-B27 positive, experience temperature variations with increasing incidence of flare-ups in transitional months in Connecticut.

  PublisherDOI

• Publication misrepresentation among ophthalmology residency applicants and its correlation with match success

  Journal of Academic Ophthalmology · 2024-11-17

  articleOpen accessSenior author

  Purpose: To determine prevalence of publication misrepresentation in SF match applications to a single US ophthalmology residency program between the 2017-2018 and 2021-2022 match cycle and its impact on match success. Methods: Applicant characteristics and publications listed were recorded. Publications were searched and verified in PubMed, Google Scholar, and the journal or conference’s website. Applicant characteristics were compared with 2 test and t-test. Predictive factors for misrepresentation were analyzed using multivariate logistic regression that adjusted for relevant covariates. Results: Our cohort included 1,165 applications and 4,467 publications with an average of 4.9 publications per applicant. From the 2017 to 2021 match cycle, the mean USMLE Step 1 score (239.8 vs 243.6, p=0.0081), Step 2 score (248.1 vs 252.6, p=.0001), and percentage of applicants with AOA status (11.5% vs 22.6%, p = Discussion: Publication misrepresentation has significantly increased over the years, possibly related to the increase in research productivity required by residency programs. Potential methods to decrease misrepresentation include requiring a publication’s DOI, providing clearer descriptions for publications categories, and allowing applicants to amend publication statuses.

  PublisherDOI

• Antibiotic Prescribing Patterns Among U.S. Ophthalmologists and Optometrists from 2018 to 2021 in the Medicare Part D Database

  Journal of Ocular Pharmacology and Therapeutics · 2024-01-11 · 1 citations

  articleSenior author

  Purpose: To assess antibiotic prescribing patterns among ophthalmologists and optometrists from 2018 to 2021. Methods: This is an observational, retrospective cohort study of the Medicare Part D prescriber public use files from 2018 to 2020. Prescription trends were analyzed with analysis of variance and negative binomial regression tests based on specialty, region, and types of antibiotics. Results: From 2018 to 2021, the number of ophthalmologists in the Medicare Part D database decreased from 18,452 to 18,285, and the number of optometrists increased from 23,071 to 24,734. Throughout the study period, the total number and proportion of antibiotic prescriptions by ophthalmologists and optometrists stayed almost constant with a dip in 2020, likely reflecting the effects of the COVID-19 pandemic. Both ophthalmologists and optometrists demonstrated geographic regional differences in prescribing patterns. The South consistently had the highest average number of claims per provider. Of the antibiotics prescribed by ophthalmologists in 2021, 48.6% are from the fluoroquinolone class, 20.5% are from the aminoglycoside class, and 18.2% are from the macrolide class. Optometrists were found to be more likely to prescribe antibiotics in a formulation combined with a corticosteroid throughout the study period. Conclusions: Our results have shown that prescribing patterns among ophthalmologists and optometrists have demonstrated significant changes in prescriptions of microbial resistance-promoting antibiotics. These patterns persist despite nation-wide attempts to control antimicrobial resistance.

  PublisherDOI

• Referee report. For: Experience of focused workshop intervention in presentation skills - Importance of foundational skills for ophthalmologists in training [version 1; peer review: 2 approved with reservations]

  Faculty of 1000 Research Ltd · 2024-01-01

  articleOpen access1st authorCorresponding
  PublisherDOI

• Referee report. For: Experience of focused workshop intervention in presentation skills - Importance of foundational skills for ophthalmologists in training [version 2; peer review: 2 approved]

  Faculty of 1000 Research Ltd · 2024-01-01

  articleOpen access1st authorCorresponding
  PublisherDOI

• Trends in Immunosuppressive Agent Use for Non-Infectious Uveitis by US Ophthalmologists in Medicare Beneficiaries and Association with Physician–Industry Interactions

  Ocular Immunology and Inflammation · 2023-11-02 · 2 citations

  article

  PURPOSE: To report the trends of immunosuppressive drug use for non-infectious uveitis and explore their relationship with industry payments. METHODS: A retrospective review of ophthalmologists reimbursed by Medicare for the administration of adalimumab (ADA), repository corticotropin (RCI), methotrexate (MTX), and mycophenolate mofetil (MMF) between 2014 and 2018. RESULTS: = 0.025) used. CONCLUSION: From 2014 to 2018, the use of ADA and RCI increased while MMF decreased and MTX remained stable. There was a positive association between ADA and RCI use and physician-industry interactions. A causal relationship is not determined.

  PublisherDOI

• Gender Distribution and Trends of Ophthalmology Subspecialties, 1992-2020

  American Journal of Ophthalmology · 2023-05-02 · 19 citations

  articleSenior author
  PublisherDOI

Frequent coauthors

• C. Stephen Foster

  Harvard University

  14 shared

• Sutasinee Boonsopon

  Siriraj Hospital

  9 shared

• Ahmad Abdel-Aty

  8 shared

• Armin Maghsoudlou

  Staten Island University Hospital

  7 shared

• S. Amal Hussnain

  5 shared

• Renelle Pointdujour‐Lim

  4 shared

• Jenna Kim

  Yale University

  4 shared

• Jayanth Sridhar

  Olive View-UCLA Medical Center

  3 shared

Labs

• Ophthalmology Interest Group (OIG)PI

Education

• B.A.

  Mount Holyoke College

• M.D., ophthalmology

  Yale University School of Medicine